Johnson, Tyresha Dane

Johnson, Tyresha Dane is an sole proprietor health care provider with primary practice located at 5614 N Fresno St Ste 111 , Fresno CA 93710-6034. She recently has 2 registered licenses in different health care specialties including Nursing Service Related Providers / Doula, Other Service Providers / Community Health Worker. Other Service Providers / Community Health Worker is her primary health care specialty. Johnson, Tyresha Dane can be contacted via phone (832) 836-6326.

Contact Information

Primary practice address
5614 N Fresno St Ste 111 Fresno CA 93710-6034
Phone: (832) 836-6326
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Doula 374J00000X
Other Service Providers / Community Health Worker 172V00000X California

Profile Details

NPI number 1457125627
LBN Legal business name Johnson, Tyresha Dane
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 8th, 2023
Last updated Nov 8th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457125627 NPPES
California MEDICAID 1093588386

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